"Medical chaperones" should be available for pediatric exams

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NEW YORK (Reuters Life!) - Teenagers should have the option of having a “medical chaperone” present when they are going any kind of intimate physical exam, according to a new policy statement by the American Academy of Pediatrics (AAP).

In addition, the group says, pediatricians should have a medical chaperone — a nurse or a medical assistant — on hand for younger children in cases where a parent is not there, or shouldn’t be there, such as when child abuse is suspected.

“The use of a chaperone should be a shared decision between the patient and physician,” wrote Edward Curry, the statement’s lead author.

“The patient’s preference should be given the highest priority.”

The statement, published in “Pediatrics,” clarifies the group’s existing recommendations, including offering more details on when chaperones should be used and who qualifies as one. It also clarifies when chaperones should be offered to adolescent patients.

The chaperone should be a nurse or medical assistant, not a friend or family member of the patient, or the office secretary, Curry told Reuters Health.

This is due to patient confidentiality and the fact tat they understand what is going on during an exam and can assist if needed.

Doctors often see chaperones as necessary when performing a pelvic exam, but they are also recommended for other intimate exams, such as breast and rectal exams, Curry said.

“We wanted to make sure pediatricians are aware they should (have chaperones) when they do these exams as well,” he added.

With younger children, up to around age 10, a parent should always be present for any kind of physical exam, the AAP says — though Curry added that a chaperone is helpful if abuse is suspected, or when the parent “is exhibiting mental health issues” that could interfere with the exam.

Chaperones help protect both children and pediatricians, Curry said, noting that while sexual abuse by pediatricians is “rare,” it does happen. Young patients could also misunderstand a doctor’s appropriate behavior during an exam and accuse the doctor of abuse.

If a chaperone is not available, patients can refuse an exam, the AAP says. But the doctor should then offer alternatives, including referring them to another doctor.